By Charles B. Inlander

 Most people never think about negotiating charges or fees (or anything else) with a doctor or other healthcare provider.  Negotiating is something we do with a car dealer or at a flea market. But the savvy caregiver never forgets that health care is a business – in fact, the biggest business in America – and, therefore, normal business practices apply, including negotiation.

Health Care Providers Negotiate-You Can, Too

Many of us do not realize that healthcare providers negotiate fees and services every day with insurance companies, Medicare, and Medicaid (known as “payers”). These payers rarely pay the retail rate that the provider might want to charge, but instead negotiate with the provider until a mutual rate is agreed upon. They also negotiate for what services they will pay. For example, most insurers will not pay for non-reconstructive plastic surgery. Many insurers limit the number of chiropractor visits covered in a given year. This is all done through negotiation.

You can negotiate, too. Generally, doctors and other healthcare providers are willing to lower their standard fees for patients with limited incomes or special economic circumstances. This holds true especially for people without health insurance, or for services not covered by health insurance. But it is up to you to start the discussion.

Here’s the best strategy: if the quoted fee seems excessively high or is more than you can pay, tell the doctor. Indicate that you feel this is wrong or that you cannot afford such a cost. Ask if the fee can be lowered or if some other payment scheme can be devised. If you or your loved one has been using the health care provider for many years, call upon your loyal patronage. Don’t be shy about this. Remember that healthcare provider fees are like airline fares: no two people are paying the same amount for the same class of service to the same destination. You’ll be surprised at just how willing the provider is to accommodate your needs and work with you.

Negotiating Can Help You Save Money on Equipment, Too

There are other things that a savvy caregiver can negotiate with a health care provider. For example, if you are looking for medical equipment such as a hospital bed or a lift chair for the person for whom you are caring, you can often negotiate a great price on a used piece of equipment. Recently, I helped a friend get an almost-new lift chair for his mother for $200 - $600 lower than the price of the same chair brand new. Even though Medicare would have paid part of the cost of the new chair (at a full cost of $800), his mother would have had to spend $400 of her own money. By getting a slightly-used chair, she saved $200!

Hearing aids are another negotiable product. Most hearing aids are sold by local merchants and the mark-up is pretty high. They are often willing to negotiate with both long-time and new customers in order to retain your business over many years.

Don’t be afraid to negotiate with health care providers. The worst that could happen is they say no, but chances are they’ll start dealing.